Testimony to Senate Legal and Constitutional Affairs Committee

Instead of rushing to pass over-reaching legislation to meet a court-imposed deadline, parliament should focus on making a rigorous and balanced examination of the euthanasia program as a whole.

Thank you for the opportunity to address the committee. I’m speaking to you from Valleyfield Québec, on St. Lawrence Iroquoians, Mohawk and Haudenosauneega (Longhouse Confederacy) lands. 

Toujours Vivant-Not Dead Yet (TVNDY) is a project of the Council of Canadians with Disabilities to inform, unify and give voice to the disability rights-based opposition to assisted suicide, euthanasia, and other ending-of-life practices that have a disproportionate impact on disabled people, women, elders, indigenous and racialized people, and persons subject to other forms of oppression. TVNDY was founded in 2013 as a progressive, non-religious organization of disabled people and our allies. We believe that there can be no free choice to die while old, ill and disabled people don’t have a free choice in where and how we live. We recognize that the movement toward assisted death is driven by the devaluation of disabled lives captured in the phrase “better dead than disabled” and manifest in society’s inequitable application of suicide prevention policies; where non-disabled people who want to die get suicide prevention services, while disabled people get suicide completion assistance.

In its 2015 decision in Carter v. Attorney General of Canada that struck down the prohibition on physician assisted dying, the Supreme court said that protecting “vulnerable” people (such as elders, women, LGBTQI and disabled folks, indigenous and racialized people) would require a “carefully designed system imposing stringent limits that are scrupulously monitored and enforced.” The language and implementation of Bill C-14, the medical assistance in dying or MAiD law have not met the Carter mandate.  Bill C-7 compounds this failure by rolling back protections beyond what is mandated by the Québec superior court in the Truchon c. procureur général decision, and before parliament has done the five-year review required in the MAiD statute. Far from being “an exceptional measure for exceptional cases” as promised by Véronique Hivon, chief sponsor of Québec’s euthanasia law, Canada’s program already has resulted in the deaths of nearly 20,000 disabled people, many of whom also have a terminal illness.

The MAiD statute is notable for the safeguards that are missing. For example, requiring people to exercise their autonomy by taking the lethal dose themselves — as is the case in the U.S. where only assisted suicide, not euthanasia, is allowed — would reduce assisted deaths by 90%. Nor are the provision of palliative care, community supports for independent living, or even suicide prevention interventions prerequisite for MAiD eligibility. And as Katherine Sorensen learned, there is no remedy for the common practice of doctor shopping, where multiple determinations of ineligibility can be invalidated by two “yes” votes, and the family has no legal recourse. Nor did the family of Alan Nichols, who was euthanized in 2019 despite a mental illness that affected his mood and judgment, but who did not have a life-threatening medical condition. In her 2019 End of mission statement, the United Nations Special Rapporteur on the Rights of People with Disabilities, Catalina Devandas Aguilar said she was “extremely concerned about the implementation of the legislation on medical assistance in dying” as well as the lack of options for independent living. In our series of webcasts “No Free Choice” TVNDY has documented numerous examples of persons who sought assisted death because they did not have the services and supports they needed to maintain a reasonable quality of life. Offering assisted dying to people stuck in institutions raises the same issues as those noted by Ivan Zinger in the Annual Report of the Office of the Correctional Investigator. “There are three known cases of MAiD in federal corrections, … and each raises fundamental questions around consent, choice, and dignity.”  During the pandemic, disability rights activists have joined with racial and other social justice movements to declare that #NoBodyIsDisposable, yet 80% of deaths from COVID-19 have occurred in long-term care facilities.

Last year a Québec superior court in Truchon struck down the section of the MAiD law requiring that the person’s natural death be “reasonably foreseeable.” By choosing not to appeal this decision, the Liberal government signaled its approval of the euthanasia of disabled people who are not near the end of life. Then, rather than limiting its legislative response to the scope of the Truchon decision, the Liberal government set forth a bill that makes substantive amendments to the MAiD program before the five-year review mandated by Bill C-14 has been accomplished.

Bill C-7 would reduce the number of witnesses required to sign the written request from two to one, and allow that person to be a care provider, thus setting the stage for an abusive attendant to coerce a person to ask for death, and then serve as the only witness to the request. Instead of clarifying what it means for someone’s natural death to be “reasonably foreseeable” — or scrapping the slippery and malleable concept altogether — Bill C-7 puts those folks on a fast-track to death.  The bill would eliminate the ten-day reflection period, as well as the requirement that the person be able to confirm their consent when the lethal injection is given; thereby creating a de facto advance directive. So even if a person must wait weeks to see if an antidepressant will relieve their emotional distress, or months to get access to palliative care, they can get the deadly dose right away.  That person with the abusive caregiver mentioned earlier; no one will even blink if they’re euthanized the same day they’re approved (as happened in Québec).

The Liberals further propose to limit the scope of what will be considered in the mandated five-year review. Instead of looking at “the provisions enacted by this Act” and “the state of palliative care in Canada” the Liberal government has decided to focus instead on expanding eligibility “to requests by mature minors, to advance requests and to requests where mental illness is the sole underlying medical condition.”  Those questions must absolutely be aired in a public forum, since the working groups of the Council of Canadian Academies didn’t make it easy for the public to have input into their 2018 studies. However, doing so is not a substitute for an in-depth review of the entire MAiD law and its impact. 

Instead of rushing to pass over-reaching legislation to meet a court-imposed deadline in the midst of a pandemic, parliament should concentrate on performing a rigorous and balanced examination of the euthanasia program as a whole.  Parliament must determine whether the MAiD law satisfies the mandate set out by the Supreme Court in the Carter case, whether the monitoring system is robust enough to detect problems, prevent the deaths of ineligible persons and impose consequences for those deaths. The five-year review could also answer the question whether it’s possible to enforce the MAiD law, let alone if it’s being enforced. Anything less would be a betrayal of the democratic process and the public trust. Thank you.